Successful Treatment of Calciphylaxis With Pamidronate

Authors

  • Nakysa Hooman Department of Pediatric Nephrology, Ali-Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran
  • Rama Naghshi-Zadiyan Department of Pediatric Nephrology, Ali-Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran
  • Mitra Mehrazma Department of Pathology, Ali-Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran
  • Fariba Jahangiri Department of Pediatric Surgery, Ali-Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran

Abstract

Calciphylaxis is a complication of chronic kidney disease characterized by necrotic lesion in the skin. Histological examination reveals microcalcification of medium-sized blood vessels. We report on a 21-month-old girl with end-stage renal disease with severe calcium-phosphate imbalance. Calciphylaxis process started when she received calcium gluconate intravenously the day before the surgery to correct hypocalcemia and continued progressively despite peritoneal dialysis and forced stopping calcium-containing medication. Pamidronate, 0.5 mg/kg/d, was administered for 6 days and then once a week for 5 weeks. After 1 week, the skin lesion started to heal and circulation improved, and after 6 weeks, all skin lesions completely recovered. Pamidronate was effective to stop calciphylaxis in this case with advanced renal insufficiency and severe calcium-phosphate imbalance. Medical or surgical debridement are not suggested and lesions might recover without scar by pamidronate.

Author Biographies

  • Nakysa Hooman, Department of Pediatric Nephrology, Ali-Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran
    Associate Professor, Department of Pediatric Nephrology, Ali-asghar children hospital, 
  • Rama Naghshi-Zadiyan, Department of Pediatric Nephrology, Ali-Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran
    Senior Fellow of Pediatric Nephrology, Department of Pediatric Nephrology, Ali-asghar children hospital, 
  • Mitra Mehrazma, Department of Pathology, Ali-Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran
    Associate Professor, Department of Pathology, Ali-asghar children hospital, 
  • Fariba Jahangiri, Department of Pediatric Surgery, Ali-Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran
    Assistant Professor, Department of Pediatric Surgery, Ali-asghar children hospital, 

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Published

2015-01-20

Issue

Section

CASE REPORT | Dialysis